Pulmonary Carcinosarcoma

¹ Department of Surgery, University of California School of Medicine, San Francisco

Carcinosarcoma is an uncommon pulmonary malignancy. Seven cases have been added to the 24 previously reported in the literature. The clinical findings caused by these lesions are similar to those of ordinary carcinoma of the lung except that the endobronchial type tends to grow in a fingerlike fashion along major bronchi and may be attached only tenuously at one or several points along the bronchial wall. The parenchymal type has local invasive characteristics similar to pulmonary carcinoma arising in a corresponding location. It appears to be more aggressive in its metastasizing ability than does the endobronchial type. Carcinosarcoma of the lung has a poor prognosis, and widespread metastases involving multiple organ systems in the several body cavities are common findings at autopsy. Of the 31 patients with this unusal pulmonary lesion who have been reported so far, only 6 (or perhaps even less) are still alive. The diagnosis is difficult to make prior to thoracotomy or autopsy. Mediastinoscopy should be of value for both diagnostic and therapeutic considerations. Early resection is preferable, although radiation treatment may be of benefit.

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